Letter by Le Faucheur et al Regarding Articles, “Six-Minute Walk Is a Better Outcome Measure Than Treadmill Walking Tests in Therapeutic Trials of Patients With Peripheral Artery Disease” and “The Treadmill Is a Better Functional Test Than the 6-Minute Walk Test in Therapeutic Trials of Patients With Peripheral Artery Disease”

Faucheur, Alexis Le; Müllenheim, Pierre-Yves de

doi:10.1161/circulationaha.114.012389

Cited by 9 publications

(5 citation statements)

References 5 publications

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“…As assessed during the medical appointment. b According to our inclusion criteria, PAD participants' leg symptoms that fell within the following leg symptom categories 13 could be included in the study: (i) Intermittent claudication. Patients that experience exertional calf pain that does not begin at rest and that forces them to stop walking and that relieves or lessens within 10 minutes of rest; (ii) Atypical exertional leg pain/stop.…”

Section: Outdoor Walking Sessionmentioning

confidence: 99%

“…Considering only the number of valid days at the group level, on average, the PAD participants experienced a WPM only twice per day and an SIWP only once a day ( Table 4). As shown in Table 4, this group of PAD participants spent 64% [52-72] of their daily time engaging in sedentary behavior and 8% [5][6][7][8][9][10][11][12][13][14][15] of their time engaging in moderate-to-vigorous physical activity. Furthermore, the number of bouts ≥10 minutes with a string of consecutive counts values ≥760 counts/min was very low, that is, 2 [1][2][3][4][5][6][7][8].…”

Section: Lower Limb Pain Manifestations and Associated Functional Lmentioning

confidence: 99%

“…3,9,10 This issue is a serious concern for clinical decision-making and research purposes because the consensus opinion supports that the optimal functional test should be correlated with patient-reported ambulatory function in daily life. [11][12][13][14] An accurate ambulatory measurement of the outdoor walking capacity has been proposed using Global Positioning System (GPS) receivers. 6,7,15,16 However, as currently used, the onset of walking pain cannot be retrieved from an analysis of a GPS speed signal, which precludes the estimation of the PFWT and a full assessment of the pain experienced during "natural" outdoor walking.…”

Section: Introductionmentioning

confidence: 99%

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Using wearable monitors to assess daily walking limitations induced by ischemic pain in peripheral artery disease

Chaudru

Jéhannin

Müllenheim³

et al. 2019

Scandinavian Med Sci Sports

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and ENS Rennes. S. Chaudru received grants from the Bretagne region (Bourse ARED) and the SFETD/APICIL foundation. P.-Y. de Müllenheim received a PhD scholarship from the École normale supérieure de Cachan-Antenne de Bretagne (CDSN).Purpose: To develop, assess the feasibility of, and determine the clinical validity of an event-based analysis method using wearable monitors to quantify walking pain manifestations (WPMs) and stops induced by walking pain (SIWPs) during daily life walking in people with peripheral artery disease (PAD). Methods: The following two conditions were studied: a standardized outdoor walking session (OWS) and a seven-day free-living measurement (FLM) period. The PAD participants (n = 23) wore an accelerometer and a watch. They were asked to press the event marker button on the watch to indicate events related to WPMs and SIWPs. To assess the clinical validity of the method, the computed pain-free walking time (PFWT) and maximal walking time (MWT) were compared with the PFWT and MWT assessed using standard treadmill walking protocols, respectively. Results: Following OWSs, the PFWT [OWS] and MWT [OWS] were significantly correlated with the PFWT [Strandness] (r = .955, P < .001) and MWT [Strandness] (r = .821, P < .001), respectively. During the FLM, PAD participants experienced only 2 WPMs/day and 1 SIWP/day, although severely limited on the treadmill and during the OWS. The average WPMs/day were moderately correlated with the PFWT [Strandness] (r = −.54, P = .016). The PFWT [FLM] was on average 12 times longer than the PFWT [Strandness] . Interestingly, the intensity of the walking bouts as assessed by the accelerometer counts during the FLM was significantly lower than that during the OWS (45 ± 15 vs 66 ± 20 counts/s, P < .001). Conclusion: This new method offers opportunities for studies investigating the experience of living with PAD and the assessment of daily life walking capacity for both diagnostic and therapeutic purposes. K E Y W O R D S accelerometry, event history analysis, intermittent claudication, physical activity, walking 1814 | CHAUDRU et Al.

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Section: Outdoor Walking Sessionmentioning

confidence: 99%

Section: Lower Limb Pain Manifestations and Associated Functional Lmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Using wearable monitors to assess daily walking limitations induced by ischemic pain in peripheral artery disease

Chaudru

Jéhannin

Müllenheim³

et al. 2019

Scandinavian Med Sci Sports

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“…Compared with previous studies [12,14,49], the ELECTRO-PAD clinical trial will assess the walking capacity of PAD participants through three complementary walking assessment tests: the modified Strandness treadmill test, the six-minute walking test, and a GPS-assessment of outdoor walking capacity. Although this increases the complexity of the protocol, this methodologic choice was deemed important considering the existing controversy about the best functional test for measuring response to interventions in PAD [31,53,54]. It has been shown that walking capacity assessment tests provide outcomes that are not interchangeable in participants with PAD [55].…”

Section: Discussionmentioning

confidence: 99%

A Multicenter, Investigator-Blinded, Randomized Controlled Trial to Assess the Efficacy of Calf Neuromuscular Electrical Stimulation Program on Walking Performance in Peripheral Artery Disease: The ELECTRO-PAD Study Protocol

Faucheur

Jéhannin

Chanteau

et al. 2022

JCM

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This paper describes a currently on-going multicenter, randomized controlled trial designed to assess the efficacy of calf neuromuscular electrical stimulation (NMES) on changes in maximal walking distance in people with lower extremity peripheral artery disease (PAD), compared with a non-intervention control-group. This study (NCT03795103) encompasses five participating centers in France. PAD participants with a predominant claudication at the calf level and a maximal treadmill walking distance ≤300 m are randomized into one of the two groups: NMES group or Control group. The NMES program consists of a 12-week program of electrical stimulations at the calf-muscle level. The primary outcome of the study is the change in maximal treadmill walking distance at 12 weeks. Main secondary outcomes include changes in the pain-free treadmill walking distance; 6 min total walking distance; global positioning system (GPS)-measured outdoor walking capacity; daily physical activity level by accelerometry; self-reported walking impairment; self-reported quality of life; ankle-brachial index; and skin microvascular function, both at the forearm and calf levels. Recruitment started in September 2019 and data collection is expected to end in November 2022.

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“…The two most common functional tests used in PAD are the treadmill walking test and the 6‐min walk test (Hiatt et al., ; McDermott et al., ). Despite being keystones in PAD management, controversies remain as to whether the treadmill walking test or the 6‐min walk test is the better functional test (Hiatt et al., ; McDermott et al., ; Le Faucheur et al., ). However, consensus supports that an optimal functional test should directly correlate with the patient's physical limitations in their “real‐life” setting (Hiatt et al., ; McDermott et al., ).…”

mentioning

confidence: 99%

Clinical Interest of Ambulatory Assessment of Physical Activity and Walking Capacity in Peripheral Artery Disease

Müllenheim

Chaudru

Prioux

et al. 2015

Scandinavian Med Sci Sports

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The purpose of the present review was to provide, for the first time, a comprehensive analysis and synthesis of the available studies that highlighted the clinical interest of the ambulatory assessment of either physical activity (PA) or walking capacity in patients with lower extremity peripheral artery disease (PAD). We identified 96 related articles published up to March 2015 through a computer-assisted search of the MEDLINE, EMBASE, and Web of Science databases. Ambulatory-measured PA or related energy expenditure (EE) in PAD patients was performed in 87 of the 96 included studies. The main clinical interests of these measurements were (a) the assessment of PA/EE pattern; (b) the characterization of walking pattern; and (c) the control of training load during home-based walking programs. Ambulatory-measured walking capacity was performed in the remaining studies, using either Global Positioning System receivers or the Peripheral Arterial Disease Holter Control device. Highlighted clinical interests were (a) the assessment of community-based walking capacity; (b) the use of new outcomes to characterize walking capacity, besides the conventional absolute claudication distance; and (c) the association with the patient's self-perception of walking capacity. This review also provides for the clinicians step-by-step recommendations to specifically assess PA or walking capacity in PAD patients.

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Cited by 9 publications

References 5 publications

Using wearable monitors to assess daily walking limitations induced by ischemic pain in peripheral artery disease

Using wearable monitors to assess daily walking limitations induced by ischemic pain in peripheral artery disease

A Multicenter, Investigator-Blinded, Randomized Controlled Trial to Assess the Efficacy of Calf Neuromuscular Electrical Stimulation Program on Walking Performance in Peripheral Artery Disease: The ELECTRO-PAD Study Protocol

Clinical Interest of Ambulatory Assessment of Physical Activity and Walking Capacity in Peripheral Artery Disease

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